We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Vaginal matrix metalloproteinase-9 (MMP-9) as a potential early predictor of preterm birth.
- Authors
Davis, Jay A.; Baker, David; Peresleni, Tatyana; Heiselman, Cassandra; Kocis, Christina; Demishev, Michael; Garry, David J.
- Abstract
To evaluate the differences in vaginal matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMPs) in pregnant patients with a history of prior preterm birth compared with controls. A prospective cohort pilot study recruited patients during prenatal care with history of prior spontaneous preterm birth (high-risk group) or no history of preterm birth (low-risk/controls). Inclusion criteria were singleton gestation at 11–16 weeks and between 18 and 55 years of age. Exclusion criteria were diabetes mellitus, hypertension, diseases affecting the immune response or acute vaginitis. A vaginal wash was performed at time of enrollment, and patients were followed through delivery. Samples were analyzed using semi-quantitative analysis of MMPS and TIMPS. The study was approved by the IRB and a p-value <0.05 was considered significant. A total of 48 pregnant patients were recruited: 16 with a history of preterm birth (high-risk group) and 32 with no history of preterm birth (low-risk group/controls). Groups were similar in age, race, BMI, and delivery mode. The high-risk group had more multiparous women (100 vs. 68.8 %; p=0.02), a greater preterm birth rate (31.2 vs. 6.3 %; p=0.02), and a lower birth weight (2,885 ± 898 g vs. 3,480 ± 473 g; p=0.02). Levels of vaginal MMP-9 were greater in high-risk patients than low-risk patients (74.9 % ± 27.0 vs. 49.4 % ± 31.1; p=0.01). When dividing the cohort into patients that had a spontaneous preterm birth (7/48, 14.6 %) vs. those with a term delivery (41/48, 85.4 %), the vaginal MMP-9 remained elevated in the cohort that experienced a preterm birth (85.46 %+19.79 vs. 53.20 %+31.47; p=0.01). There were no differences in the other MMPS and in TIMPs between high and low-risk groups. There was an increase in vaginal MMP-9 during early pregnancy in those at high risk for preterm birth and in those who delivered preterm, regardless of prior pregnancy outcome. Vaginal MMP-9 may have potential as a marker of increased risk of preterm birth.
- Subjects
PREDICTION models; BODY mass index; DELIVERY (Obstetrics); RECEIVER operating characteristic curves; PREMATURE infants; MOTHERS; PILOT projects; LOGISTIC regression analysis; AGE distribution; DESCRIPTIVE statistics; LONGITUDINAL method; RACE; ODDS ratio; MATRIX metalloproteinases; BIRTH weight; COMPARATIVE studies; CONFIDENCE intervals; SENSITIVITY &; specificity (Statistics)
- Publication
Journal of Perinatal Medicine, 2024, Vol 52, Issue 6, p591
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2023-0429